Update: Life on internal medicine

My internal medicine rotation is off to a pretty good start! I’m 2 weeks in now. I’m working at our VA hospital taking care of patients with complicated past medical histories. All of the patients that our team has taken on since I’ve been here are older men–many with poor lifestyle choices that have led them to where they are now. I’m slowly learning some of the many algorithms for treating COPD, heart failure, and kidney injuries. Since I’ve started, I have definitely grown more confident in my management plans for my patients, and become more comfortable being wrong. No medical student likes to be wrong, but I think it’s way better to still offer something and to learn why it’s incorrect, than to not offer anything at all–especially when it’s concerning your patient. I want to make sure I’m seen as an active participant in their care.

The residents and attending physicians I’ve worked with for the past two weeks have been instrumental in helping me along the learning curve. Every teaching opportunity is taken advantage of, and my questions are answered fully. At the same time, they push me to read and learn more on my own so they aren’t just handing me everything. During my evaluation with my attending, he was saying that my curiosity was one of my better assets. But he said it like three times, so in the back of my mind I wonder if he thinks I ask too many questions haha. I’m sure he meant well. But I definitely don’t hesitate to ask for quick explanations. I like to give a possible answer as I ask the question, so at least it seems like I put thought into it before just asking. Ex. “Is the reason why the creatinine levels spiked today because the patient is dehydrated? (even though that might be a complete guess)” vs. “Why is the patient’s creatinine up today?”

For our schedule, everyday starts at 7 and we’re on call from 7a-7p every 4 days which is when we get all of our admissions (new patients), whether from the Intensive Care Unit or the Emergency Department. On the other days we’re there until 4 latest, but I’m usually let out earlier. No one likes being in the hospital all day long, but call days are the best for me as a student. I get to go to the ED and see the patient first, work them up, and come up with my problem list and plan for the patient. After the resident sees them I’m able to report to them and we solidify the plan together. They teach me how to prioritize the different problems, the right wording for what I’m trying to say, and the right work up for the patient. I learn SO MUCH from just one patient (because they usually have a million things going on).



In other news, yesterday, I was inducted into the Gold Humanism Honor Society! They induct 15% of the medical school class based on nominations from our classmates and review of our CVs. I was so humbled that enough of my classmates felt so highly of me! And it’s amazing that there’s such a high honor given to students for simply being good people, no matter what your GPA is.


SN: Today was my first day off in a while. So refreshing, even if most of it was spent studying. I look at the residents and just wonder how I’m going to be able to handle the workload they have. Hats off to all the residents out there!
– Today was also the first time one of my patients died, ironic and sad that I wasn’t in the hospital to be with the family 😦

SSN: Congratulations in advance to all the 4th years matching this week!!! May God’s plan for your lives manifest in entirety.

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Trauma Surgery: Expectations vs. Reality

When I signed up for 2 weeks of Trauma surgery in my third year, I just knew it was going to be action packed. I wanted to get out of my comfort zone and be pushed to work under pressure. I even figured doing it at my institution would be the best place because we’re the Level 1 trauma center in our area. I really imagined it being a highlight of my clinical rotations. ABCs, ex laps, chest tubes, gun shots, all of that! I was ready. So just imagine the look on my face (well, the thoughts in my mind since I’ve learned how to save face) when my classmate and I meet our resident on the first day and he says “you guys don’t go to the OR on this rotation.” All my dreams were crushed.

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We work with the resident who manages the patients on the floor. It’s our job to read up on the patients hospital course and answer the question What’s keeping them in the hospital? So I just get to read about all the crazy stuff that happens as opposed to being let in on all of the action. Basically feels like any other inpatient medicine service. We get to the hospital early to pre-round, then round with the trauma team, then follow up on what we need to do for the patients based on rounds. At this point, we (medical students) are sent home and the resident stays behind to man for floor. We don’t have access to put orders in so it’s really hard to be useful.

So am I learning stuff? Absolutely. Management of the complex injuries in patients with gun shots, stabs, falls, electrocutions, etc with different hospital teams coordinating their care is super educational. Right now, I have 5 patients that I’m following, and each of them are teaching me something different. However, it’s definitely not the experience I was hoping for. I guess it’s still a part of trauma surgery. But when you don’t plan on going into surgery, you really want to see as much surgery as you can. So that was disappointing. I did get to go to the OR once and that was for my patient who needed debridement of his foot wound (exit wound from a 14000 volt electrocution). I got a really good lesson/review about burns from my attending that day. (In case you didn’t know, there’s no such thing as 1st, 2nd, 3rd degree burns anymore–they’re changing the terminology to superficial/deep partial thickness and full thickness burns).

With my shelf exam coming up on Friday, I’m actually really not pressed to be in the OR very much anyway since I use every free moment to study, and each day is basically a half day. If I had this rotation toward the beginning of my 8 week surgery stent, I’d be pretty unenthused about it. I’ve just never heard of a surgery rotation where you don’t…go to surgery! But anyway, please keep me in your prayers for my shelf exam this week! I’ll write another post about my study resources/schedule for my preparation, but for now it’s back to work!

Thank you for reading! Enjoy your week! Subscribe on your way out if you haven’t already!

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How to be the most efficient with your study time

In third year, you lose control of your schedule and are left at the mercy of your dead fuck my life GIFattending and residents. With the early mornings and early evenings, by the time I get home, I only have a few hours to study. Especially if I go to the gym, things are even more constrained. And I’m not the type to stay awake late, I’m surely in bed by 11. So, when I sit down to study, I have to be efficient. Here are some tips to help you maximize your time.

First and most important is to make a SCHEDULE. Before you sit down to study, you should already know what you’re about to accomplish. This way you keep yourself on track and can sense if you’re getting behind. You can do this day-to-day with to do lists, but to be most successful, you want to make this schedule at least on a weekly basis. On Sunday, you can generally map out what you plan to accomplish that week. Then each day, before sitting down, review that plan and make amends based on the amount of time you have to study that night. Particularly during third year, when you already know what resources you want to get through, you can actually plan out your study schedule entirely before the rotation starts, then make changes to it as you go along (this is what I do).

phone call GIFWhen you sit down you need to minimize distractions. Turn your computer notifications off and put your phone on do not disturb. I usually keep my phone in another room or on the floor out of my sight. You can check up on messages/DMs/snaps during a break, but never mix your studies with your social life if you’re trying to be efficient. If you aren’t in an ideal location, plug your ears or listen to your favorite background noise with headphones.

Take advantage of your time during the day to decrease the amount of other random things you need to do at night when it’s study-time. Respond to emails, online shop, do busy work for school, work on the application, etc. Do these more mindless things before trying to squeeze in studying during the day–which actually requires brain power. So when it’s time to focus on studying, you won’t have so many little tasks to complete beforehand and waste time.

Lastly, you need to intentionally prioritize your studying. Seems intuitive, but if you don’t believe that your readings/questions/review/etc. are top priority in that time period, you will easily find distractions and reasons to do other things. You might find yourself cleaning something, constantly getting stuck on instagram, fiddling with another hobby of yours, or caught up on the phone with friends/family. So when you say the next 2 hours you are going to finish X, Y, and Z, you need you be firm and really mean that!

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Hope these tips help you next time you prep for a study session! Have a wonderful week, and Happy Valentines Day in advance!

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Surgery–A pleasant surprise!

I’ve just wrapped up the first four weeks of my 8 week surgery rotation. I spent this first half doing general surgery in Albany, GA which is a rural city in south Georgia. My preceptor ended up taking a week vacation during my time there, So I got to spend a week with a surgical oncologist (who operates on cancers) in the middle of doing general.

Going into surgery, I automatically expected myself to not like it. I never really saw myself in that light. Even during OBGYN, I wasn’t really gravitating to the surgical side of things. Plus, I already had pre-conceived notions/biases as to the personalities of surgeons and how they treated people who weren’t surgeons. I developed these over time mainly from tv (don’t judge me) what I heard about other student’s experiences. I don’t know any surgeons first-hand so that’s what happened. But man when I tell you everything I thought about surgeons was knocked down! I mean I even considered becoming a surgeon–seriously. The doctor I worked for is in private practice, which means he really has control over his hours and workload. His lifestyle was fantastic (besides being on call). He doesn’t work/barely works Fridays, and his family is his main priority. He even coaches his son’s baseball team! He was so humble and gave credit to God for everything he did for people. I was so impressed. Shocked, honestly.

Outside of all that, the patient interactions we had were very compassionate. He had patients he’s been seeing for years because of their complicated gastrointestinal diseases. He knew their families because they would choose him to operate on their loved ones. He had continuity that I thought I would only see in primary care. And then the whole idea of surgery began to appeal to me. That feeling of doing something for someone, deciding when and how to intervene in order to have the best outcomes. It was awesome, so I definitely contemplated my life a few times in the last weeks. In reality though, surgery doesn’t give me the level of patient care and continuity that I want to have, and the ratio of OR/clinic time was a bit much for me. Also, the physical demands of the specialty on my body are no joke. I need to put something in my mouth every 2-3 hours otherwise I get headaches. I felt myself actually getting upset after we’d be in the OR more than 3 hours because my back, neck, and/or feet were hurting. So, logistically, I know it’s not the specialty for me. However, it did make me realize that I want to be able to do procedures in my practice, so I will set my sights on more procedure heavy family medicine programs.

They always tell you to have an open mind when going into your different rotations because you never know how you’ll like things. I see why! I’ve so far loved surgery. Now, most of why I feel this was is because I went away to a off-camus site to do this rotation, so it was just me and my preceptor–no cranky residents. Now that I’m back in Augusta, I’ll be on the orthopedics and trauma services over the next 4 weeks at the main hospital. I suspect that my current sentiments may change as I re-enter the hierarchy of the teaching hospital. But regardless, I’m keeping an open mind and hopefully will find more things to enjoy in the specialty.

Hope you have a wonderful week!

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Life in the fast lane

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Me trying to catch up with life

We’re 3 weeks in to 2018 and I already feel like my life is propelling way too fast. During first and second year it was just one day at a time, one block at a time. Last semester for the most part was just one rotation at a time. But now all of that has changed! A week into January, we had to declare our specialties to our school and got advisors in our fields to help us moving forward. I proudly declared Family Medicine, which I’ll probably go into my reasons in another post. Then 2 weeks later they opened up the portal for us to plan out our entire 4th year! We have to determine when we want to do electives, away rotations, and our core rotations for the year. It’s a tad overwhelming for someone who barely even has a list of residency programs she’s interested in. I thought that would be my first step, but nope!

In the midst of all that, I submitted my application for STEP2, which cost me $1895 (should be illegal the way people make money off of us). I’m still traumatized by STEP1 and I’m already planning for the next test, which really shouldn’t be as bad from what “they” say. Meanwhile I’m only 3/8 weeks into my surgery rotation (which I have surprisingly been loving!) and I’m just trying to get through my UWorld sets and pages of Pestana’s each night!

Ish is getting REAL y’all! Everything is snowballing. Today I’m thinking about my surgery shelf exam, tomorrow I’ll be checking my email for the notification that I matched (in Jesus name). I’m excited to keep moving forward, but a piece of me kind of wants things to slow down again so I can wrap my head around it all and feel a little more control. I just feel this sense of unpreparedness, but everyone just says that everything is going to work out so not to worry. Easier said than done if we’re being honest. I’m a medical student, it’s kind of my nature to worry.

But these are problems that I’m grateful to have. Honestly, I couldn’t ask for better problems. I’m confident that in the end, everything will indeed be just fine, even if the path from A to B doesn’t look very clear at all at the moment. In the meantime, I’m still forcing myself to take things one day at a time, because I don’t have the energy to spend on stressing myself out, especially when I serve an awesome God. *kicks feet up*


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Dear young lady watching,

I want to remind you that you were set on this earth for a purpose greater than yourself. You are not here by mistake. And the dreams and goals that lie in your heart are not there by happenstance. To reach your goals it will take an enormous amount of effort, but be confident that you are equal to the task because you have a higher power in your corner that can move mountains. You can’t give up because whether you know it or not, there is a #youngladywatching you! There will be voices in your head and doubt in your heart but you cannot let those penetrate into your destiny. Failure and rejection may come, but those things don’t determine your worth. Stay kind, remain humble, and always try to leave people better than you found them.

As a woman, and even more-so as a minority woman, you are likely to find yourself discredited, belittled, muted on your journey to and through medicine, especially within male-dominated specialties. You may not look like the majority of your classmates,  professors, or preceptors, but know you are not alone! You may, like me, find yourself sitting in an operating room lounge surrounded by white male surgeons who move around like you don’t exist. The desire to pursue a highly competitive specialty may be met with skepticism. People will doubt your abilities and judge you simply by the way you look. But it’s important to know again that you are not alone. There are women going before you, and with you, reminding you that all things are possible for those who work hard and believe. I serve as an example of one, and I hope that just my presence and journey through medicine will inspire another young lady to choose medicine and stick with it.

  • 22% of academic medicine professors are women.
  • Women make up 22% of surgeons in the US.
  • African-American women make up 4% of physicians in the US.
  • African-American women make up 2-5% of surgeons in the US.

The path to medicine, though arduous, culminates into the most noble and rewarding profession. And there’s a lot of maturation that has to take place before I’m even worthy of those two little letters behind my name. I’ve grown so much in just two and a half years of medical school, and I look forward to more challenges and failures, but also more wisdom and success. The best thing is that I’ve learned to put my wellbeing first and actually enjoy this crazy ride, and I encourage you to do the same.


This post was inspired by two family medicine physicians Dr. Lauren Powell and Dr. Kristamarie Collman who recently began the #youngladywatching movement on Instagram to empower women in medicine. I’m the young lady looking up to them and I wanted to uplift those watching me. Search the hashtag to find more inspiring stories!

Family medicine wrap up: tips to be successful on this rotation

My tips to help you rock the family med rotation/shelf!

It’s Christmas Eve and this is actually the last thing I want to be thinking about, but I know the longer I wait, eventually I’ll forget all of my pearls. So lets get to it shall we…

In terms of the rotation itself, if you enjoy clinic, you’ll thrive in Family medicine. For the most part, that’s the gist of it. On my rotation, we also did hospitalist work each morning, but that’s not a common experience. (1) I would use every patient that comes in for routine visit to help you memorize the guidelines set by the USPSTF. Those are super important to have memorized and get you easy points on the shelf exam. Knowing the guidelines can also help you shine clinically, as they are often pimp questions, and can improve your assessment and plan. (2) Another tip, always pay attention to what the patient is allergic to. There’s a lot of go-to medications for different things and you don’t want to be too quick to suggest something harmful. (3) If you don’t have access to the electronic records at your site, you can still show initiative if there are paper charts available. (4) Be willing to ask the nurses to help sharpen any ancillary skills you want to work on. (5) As soon as you see/hear something that you don’t know–look it up. You’ll remember it better when you learn it in the context of a patient vs. reading about it later in case files.

Outside of the rotation, I was sacrificing time for my family trying to be a good sister, daughter, and auntie. My self care went out of the window–again. I probably went to the gym twice, if that. I really let stress eat me, literally–I lost weight by the end of the rotation. Third year is just so much harder for me to fit everything in! And this rotation with this 30 minute commute really sucked my time away from me! One thing I was able to do was continue to wash/co-wash my hair regularly each week, so I’m proud of that, because that is a time-consuming process.

Shelf Exam (end of rotation exam)

First of all there is no magic formula to the Family medicine shelf exam. I never felt like I was ready to take it. There are recommended resources out there but even still.. it’s just a wide open exam that throws everything at you. I began the week before (I was on palliative care) with reading the Ambulatory Medicine section of Step up to Medicine and doing PreTest Questions. Once the rotation started, I was doing AAFP Q’s during the clinic day between patients and PreTest Q’s + OME videos + Case Files at night (I just watched whatever videos I felt were relevant). I took bulleted notes on the CF cases as I read them. I finished PT in 2 weeks and didn’t redo my missed questions until the weekend before the exam. I switched focus to AAFP Q’s and I finished them and CF a week before my exam. I did them all through the day, through my lunch break, and at home after work along with more OME videos. I read 2-3 CF cases each night on average. I took the 2 practice NBME’s available which were pretty difficult and random (like the actual exam). I didn’t meet the threshold I needed on either one of them so that just emphasized me not feeling ready. I think my actual exam had a lot more preventative medicine on it compared to the practice tests that at some points made me feel like I was on internal medicine. I did see practice NBME Questions on my exam. Anywho, the week of the exam I reread the ambulatory medicine section, studied my notes from OME and CF, did more repeat AAFP Questions, did the 125 UVA questions (highly recommend) and searched SDN to make sure I wasn’t forgetting anything lol. There was nothing else I could do but pray and go in and do my best then continue to live my life.

I’d say my favorite resources were Case Files as a text and the PreTest questions. These two taught me the most information. I thought PT was more relevant to the shelf compared to AAFP (but getting outdated so watch out for changes in management). The AAFP Questions are cool too, but it’s not presented in a way where you can review the ones you missed, so you aren’t able to reinforce as much. I felt like I was just doing them just trying to finish them. And I didn’t have the patience to be taking notes on each question, only ones that really stumped me.

All in all, despite the nasty shelf exam, I loved family medicine, and I plan to declare it as my chosen specialty! It’s really amazing what you are able to do for people in this field.

PS. NOLA was a BLAST and a much needed trip that made me forget about all of my troubles. Wishing everyone a Merry Christmas!! I hope you enjoy your time with your family/friends. Our savior is born! Have a wonderful week!


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Learning things the hard way

I spent this weekend in Miami visiting my boyfriend. But the journey getting there was full of L’s (losses)! I felt like I just couldn’t catch a break. After a series of unfortunate events, I missed my original flight and spent the next few hours trecking all over the airport trying to find another flight out. My airline didn’t have any other flights for the night so I was checking with other airlines. I’ve never missed a flight before so I felt like such a failure, like really irresponsible. And of course I’m thinking about study time lost while I’m getting my cardio in for the day/week. After many rejections and more money spent I finally reached my destination 6 hours later. I will never miss another flight in my life I’ll tell you that much.

And THEN on the way back, nobody told me that if you don’t fly on your airline out, they don’t save your return flight. So when I got to the airport for my return flight at 9am, I found that out the hard way. So I had to get yet another flight, but they still put me on standby for that flight. I was one person away from making standby -_-. Thankfully, Leslie hadn’t left the airport yet (he was taking a nap) and was able to pick me back up with no issue. Ended up leaving on a 5pm flight. I enjoyed the extra time but since I was now eating into my Sunday work day, I had to spend much of it studying. So, this weekend ended up being a heck of a lot more expensive than planned, but still worth every penny.


I took a lesson from it all though, which is why I decided to write about it instead of suppress my misfortune. You simply cannot plan everything out to the T, that’s not how life works. And when things don’t go as planned, it’s all about your attitude and how you respond that makes the difference. At first I was so frustrated and teary-eyed but I had to pull myself together and remind myself that I couldn’t change my circumstances; I just had to keep it moving with the current situation. Dwelling on the past would do nothing for me. I tried as best I could to keep my thoughts positive (emphasis on try). When you’re already in a tough spot, negativity will only add fuel to the flames that are consuming you. I’ve learned these lessons before, but I was definitely reminded of them this weekend.

Many are the plans in the mind of a man, but it is the purpose of the LORD that will stand. -Proverbs

Praise God for journey mercies though because I made it back in town safely. I’m 10 days out from my shelf exam for Family Medicine and currently not feeling very comfortable with the material, so please extend your prayers to me and my brain!

Have a wonderful week!

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How you can make a difference as a medical student on rotations

We play a small but mighty role in the lives of our patients!

It can be pretty hard sometimes to find your place as a member of the “team” while you’re on your rotations. Speaking from experience, it’s hard to feel like I’m making much of a difference. After feeling good about the patient encounter and presenting everything to the attending (including the correct diagnosis for the patient), they come in and ask all the same questions and do all the same physical exam! Of course I understand why, but I can’t help but feel a little undermined at times. If you’re in a big hospital on a team with interns and residents then you might feel even more useless, because the students in training do all of the real work. I remember feeling lost in the shadows my time on a hospitalist team. Technically I was following my own patients and would present on them, but after rounds I was pretty out of the loop, unless I forced myself into it (and I didn’t want to be that girl). So it can be pretty frustrating. But rest assured, there are ways that you can impact your patients unlike any other person, as well as make a huge difference for your care team.

We’re eager and fresh in this new environment. We haven’t been jaded by the system and we only want to do the best by our patients. Our hearts tug when we hear bad news; we give people the benefit of the doubt; we believe it when they say they’re taking their medicine. This is such a meaningful thing that patients actually notice! There’s a difference in the way a medical student talks to them versus an attending. We show them the compassion, care, and empathy that they truly need and sometimes don’t get. There are times we can do more for them than all of the medications and tests that the residents are ordering. We have the time to sit with them and get to know them more personally. This especially goes if you don’t have to write notes after your patient encounter. More practically, there are many things you can do to be a rockstar team member: print rounding reports, gather new data on patients, do extra research on topics you or the residents may be pimped on, etc.

I’ll always remember on my OB/GYN rotation, there was a patient whose child had to be transported to another hospital while she had to stay to recover. It was so hard for her to be separated from her child. I came in during pre-rounds and was a soundboard for her to express her feelings. I told her that she was going to be a wonderful mom and that the time would soon come for her to be reunited with her child. I stopped in again later in the day, and as she was being discharged, she thanked me so much for being her rock as she waited for the go-ahead to leave the hospital. And she gave me the biggest hug. She said people just came in and out of her room all day and no one cared what she was going through. In that moment I felt like I did more for her than any of the nurses or even my attending–who really just signed her discharge papers.

So just remember that even though you might not have access to the computer record to look up patient info, or you might be the third person to take the same patient history, you really can make all the difference in a patient’s life. Our worth as medical students is unfortunately defined by how good our oral presentations and differential diagnoses are. But our worth as physicians is really in the connections we make with patients and in the rapport we build with them. That’s what makes all the difference. While learning to be good clinicians, we are also learning to be good doctors.

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Have a wonderful week! Subscribe on your way out if you haven’t already!

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Life and Death

A week of palliative care has shown me a lot

I’ve spent a week on my palliative care rotation and boy has it been heavy. Palliative care is focused on quality of life and relief of symptoms, especially towards the end of life. I’m assigned to a nursing home, so not only am I exposed to end of life issues, but I’ve been able to learn about geriatric/elder patient care in general. I did a puzzle with a 94 year-old in occupational therapy and I saw a patient around the same age in her last days of life. It’s been quite the ride.

Earlier in the week I was part of a very delicate conversation concerning one of our patients nearing the end of life. It was a team meeting with the patient’s son and grandson. Our medical director asked questions like “how do you envision a good death for the patient?” and “what are your goals for the end of life?” They were trying to think about what the patient would want, as he could no longer speak for himself. Such a delicate time for the family.

Dealing so much with death and end of life has actually made me reflect a lot on life and how we all want to life full lives. And even at old age, after living a full life, death can still come suddenly to a family. There’s never really any way to prepare for that conversation. But it’s a reminder to live each day to the fullest and take advantage of all the ways you can make a difference in people’s lives. To pursue your passions and not put a hold on your goals for life. Because at the end, we aren’t all going to be blessed with the opportunity to plan out how we or our loved ones will leave the world.

As a future physician it’s nerve-racking to think that I’ll have to have these kind of conversations with patients and their families as soon as my first year out of school. So I’m happy to be getting the small exposure I am now so that maybe when I’m more important I’ll be able to guide a family through such a vulnerable time as this.

One more week of palliative care, then Family Medicine. Stay tuned. I’m excited for the week ahead!

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